Provider Demographics
NPI:1497393763
Name:BODYSOULHEALING LLC
Entity Type:Organization
Organization Name:BODYSOULHEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMT, CCSP
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERENA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIEBELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-421-6296
Mailing Address - Street 1:1330 S 2ND ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-4804
Mailing Address - Country:US
Mailing Address - Phone:360-421-6296
Mailing Address - Fax:
Practice Address - Street 1:1330 S 2ND ST STE 103
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-4804
Practice Address - Country:US
Practice Address - Phone:360-421-6296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty